In view of the recent service demand surge in public hospitals and the heavy workload of frontline staff—due to the summer influenza peak season—the Hospital Authority (HA) announced on 17 July (Monday) that all public hospitals would suspend hospital accreditation activities immediately until 30 June 2018, to alleviate non-clinical duties of healthcare staff.

HA had a meeting with Professor Sophia Chan, Secretary for Food and Health, and the Centre for Health Protection (CHP) of the Department of Health (DH) on Monday morning to understand the latest situation of seasonal influenza. Suspension of the hospital accreditation activities is one of the measures to ease pressure on overloaded healthcare professionals.

More measures are said to be underway, including transferring suitable patients to private hospitals to vacate public hospital beds for more serious patients.

Yet, Dr Wai-lun Cheung, HA Deputising Chief Executive, refused to elaborate on details of this initiative. “We are still in a discussion stage,” he said.

Meanwhile, Dr Anthony Kai-yiu Lee, chairman of the Private Hospital Association, said private hospitals are willing to help; but he pointed out the authority needs to consider the logistics of transporting patients. He further added that there had been no official contact with the authority yet. “By the time the terms have been finalised, the crisis may be over,” he said.

Securing more manpower

Recruiting more manpower is another measure that HA is undertaking. "We understand the heavy work pressure faced by frontline staff. We have already employed 350 part-time doctors and 2200 part-time nurses to alleviate their workload. We will continue to recruit more part-time healthcare staff, including patient service supporting staff in the wards, through various channels. We will also continue to provide special honorarium to staff willing to work overtime—from doctors, nurse, allied health professionals to patient care assistants. Auxiliary Medical Service will be invited to help take care of patients waiting for consultation at busy Accident & Emergency (A&E) Departments," elaborated Cheung.

In particular, to relieve pressure of A&E Departments and for the convenience of patients with mild ailments, additional General Outpatient Clinic (GOPC) quotas will be provided. HA will invite doctors from the DH to provide service during their off-duty hours.

However, Dr Tsz-tai Chan, vice-chairman of the Frontline Doctors’ Union, pointed out asking civil service doctors to help out might be less feasible than engaging private hospitals.

“While [the DH doctors] have the medical knowledge, they might not be so familiar with the new way of doing things—it is like teaching new doctors,” he expressed.

Additionally, in view of the surge in elderly patient admissions, HA remarked that they plan to speed up the allocation of places in residential care homes for the elderly (RCHEs) for patients assessed to be suitable for discharge—by working closely with social welfare organisations via the Social Welfare Department (SWD).

"We will also enhance support to RCHEs through Community Geriatric Assessment Team, Community-based Nursing Service and Visiting Medical Officer Scheme to take care of patients with mild clinical condition outside the hospitals. Some hospitals have arranged geriatric doctors and nurses to A&E Departments to provide early assessment and treatment to patients to reduce admissions,” Cheung added.

On the demand side, Cheung said public hospitals are now reviewing if they would suspend or postpone non-emergency operations and Specialist Outpatient Clinic (SOPC) routine cases—to spare manpower for inpatient care.

Urgent measures requested by Chief Executive

The measures came right after Chief Executive Carrie Lam Cheng Yuet-ngor visited Queen Elizabeth Hospital (QEH) on 15 July and requested HA to come up with urgent solutions “in a very short period of time”.

“I have already asked the authority to work out measures very soon to ease the manpower problem. If it is something to do with resources, the government can promise to give its full support. But if even though there is money, and there is still a problem getting enough doctors, that will be a more complicated and difficult issue,” Lam said.

Professor John Leong, chairman of the HA, also paid a visit to the medical and paediatric wards and accident and emergency (A&E) departments of Tuen Mun Hospital, Pok Oi Hospital and Prince of Wales Hospital, respectively, on 14 July. He believed the resident trainees who just joined different public hospitals on 1 July could share the workload of frontline colleagues.

In response to the government’s initiatives, Cheung expressed on 17 July his gratitude to the government for providing additional resources to HA and activating inter-departmental collaboration to help public hospitals cope with the overwhelming service situation in the summer influenza peak season. MIMS

At the recent Malaysian Community Pharmacy Business Forum (MyCPBF), a discussion forum was held on the subject of “Transcending Primary Healthcare Services: The Future of Specialized Pharmacy Services and Pharmacy Specialization”.